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The Journal of Cardiovascular Surgery 2000 December;41(6):919-25

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Surgery for aortoiliac aneurysms in kidney transplant recipients

Reber P. U., Vogt B., Steinke T. M., Patel A. G., Kniemeyer H. W.

From the Department of Vascular Surgery *Department of Nephrology and Inselspital, University of Bern, Bern, Switzerland


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With the ­increase of ­long-­term sur­vi­vors fol­low­ing ­renal trans­plan­ta­tion, aor­to-­iliac aneu­rysms requir­ing sur­gi­cal man­age­ment may be encoun­tered ­more ­often. Our expe­ri­ence ­with tem­po­rary ­shunts for ­renal trans­plant pro­tec­tion dur­ing aor­to-­iliac aneu­rysm ­repair is pre­sent­ed ­along ­with a lit­er­a­ture ­review of all cas­es on the sub­ject. Three ­male ­patients ­with a ­median age of 56 (range 50-61) ­years ­were oper­at­ed on for a dis­sect­ing aneu­rysm of the com­mon ­iliac ­artery in one, respec­tive­ly abdom­i­nal aor­tic aneu­rysm in the two remain­ing ­patients. All ­patients had ­impaired trans­plant func­tion pre­op­er­a­tive­ly ­with a ­median ser­um crea­ti­nine lev­el of 167 (­range 134-202) µmol/L and a ­median ­blood ­urea nitro­gen con­cen­tra­tion of 15 (­range 9-23) µmol/L. The ­intra- and post­op­er­a­tive ­course was unevent­ful in all ­patients. Median post­op­er­a­tive ser­um crea­ti­nine lev­el and ­blood ­urea nitro­gen con­cen­tra­tion ­were 135 (­range 123-151) µmol/L and 10 (­range 9-11) µmol/L, respec­tive­ly. Aorto-­iliac sur­gery in ­renal trans­plant recip­ients can be per­formed with­out trans­plant pro­tec­tion. However, in ­patients ­with a dete­ri­orat­ed trans­plant func­tion or if a pro­longed aor­tic cross-clamp ­time is antic­i­pat­ed, ­renal allo­graft pro­tec­tion meas­ures may be ben­e­fi­cial to pre­vent pos­sible ischem­ic dam­age.

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